2024 Formulary Changes for Wellcare By Allwell
Date: 11/22/23
On January 1, 2024, some drugs will no longer be covered on our Medicare Part D Plan formulary(ies). To assist our providers, we have included the list below of the most commonly prescribed drugs being removed along with the drug’s 2024 formulary alternative(s). Please refer to the list to identify the appropriate options for your patients.
Please refer to the list to identify the appropriate options for your patients.
Product Name | Formulary Alternative(s) |
|---|---|
Lantus vial, Lantus SoloStar | Basaglar KwikPen, Toujeo SoloStar, Toujeo Max SoloStar, Tresiba vial, Tresiba FlexTouch |
Levemir vial, Levemir FlexPen | Basaglar KwikPen, Toujeo SoloStar, Toujeo Max SoloStar, Tresiba vial, Tresiba FlexTouch |
Victoza pen injector | Bydureon Bcise auto-injector*, Mounjaro pen injector*, Ozempic pen injector*, Rybelsus tablet*, Trulicity pen injector* |
Byetta pen injector | Bydureon Bcise auto-injector*, Mounjaro pen injector*, Ozempic pen injector*, Rybelsus tablet*, Trulicity pen injector* |
Flovent Diskus, Flovent HFA inhaler^ | Arnuity Ellipta, Pulmicort Flexhaler |
Kevzara pen injector, Kevzara syringe | Diagnosis dependent: Enbrel injection*, Humira injection*, Rinvoq tablet*, Xeljanz tablet*, Xeljanz XR tablet* |
Ingrezza capsule | Austedo tablet*, Tetrabenazine tablet* |
Betoptic-S suspension eye drops | Alphagan P 0.1% eye drops, Brimonidine Tartrate eye drops, Combigan eye drops |
*Prior authorization required | ^Discontinued by manufacturer
If you determine that it is necessary for your patient to continue to receive the non-formulary drug in 2024, you will need to submit a Coverage Determination request on or after December 15, 2023.
Download a printable copy of the 2024 Formulary Changes for Wellcare By Allwell (PDF).
Download the Coverage Determinations and Redeterminations for Drugs form or you can call to request authorization.
As always, thank you for your partnership and dedication to improving our members’ health outcomes. If you have any questions, please contact Medicare Pharmacy Services at 1-800-867-6564.
Provider Relations: 1-800-222-9831
Member Services: 1-877-935-8024
Prior Authorization Phone Number: 1-800-867-6564
Plan Website: www.Wellcare.com/allwellWI